Permission to Reprint Published Material by LegalZoom

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									                  PERMISSION TO REPRINT PUBLISHED MATERIAL

Date: __________________________

_____________________ (the “Owner”) has received the request of
____________________ (the “Requestor”), in a letter dated _____________________,
_____, to reproduce the Material (as defined below). The Owner hereby grants the
request on the following terms and conditions, which terms and conditions the Requestor
hereby accepts:

    (1) The published work (the “Original Work”) that is the subject of this agreement
        (the “Agreement”) is the following:

         Author:
         Title:
         Name of Publication:
         Date of Original Publication:

         The Owner is the sole copyright holder of the Original Work.

    (2) Permission is hereby granted to use the following selection from the Original
        Work:
        __________________________________________________________________
        __________________________________________________________________
        __________________________________________________________________
        (the “Material”). The Material represents approximately _________ % of the
        Original Work. [A copy of the Material is attached to this Agreement.]

    (3) The Material may be used only as follows, without deletions from, additions to, or
        changes in the text thereof:
        __________________________________________________________________
        __________________________________________________________________
        __________________________________________________________________
        __________________________________________________________________
        _______________________________________________________________.

    (4) The Material [will not be used in a seminar or other educational activity] [will be
        used in a seminar or other educational activity as follows:
        __________________________________________________________________
        __________________________________________________________________
        _______________________________________________________________.]

    (5) In consideration for the grant of the Owner’s permission to use the Material, the
        Requestor agrees to pay a one time fee of $__________________ (the “Fee”).
        The permissions granted under this Agreement shall be ineffective until the Fee is
        paid in
								
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